血浆全段甲状旁腺激素测定在肾脏疾病中的临床应用

目的:探讨全段甲状旁腺激素(i-PTH)在肾脏疾病中的临床应用价值.方法:检测和分析了46例肾功能不全失代偿期组、39例肾功能衰竭期组、35例尿毒症期组患者的全段甲状旁腺激素(i-PTH),并和41例正常对照组进行比较.结果:i-PTH浓度病例组与正常对照组有显著性差异(P＜0.01),各组间i-PTH也有显著性差异(...     

甲状旁腺激素RIA用于甲状旁腺疾病的诊断

甲状旁腺激素ＲＩＡ用于甲状旁腺疾病的诊断周安兰，王自正，杜同信甲状旁腺疾病能引起血钙、血磷的变化。但能引起钙磷变化的原因很多，甲状旁腺功能亢进（甲旁亢）及甲状旁腺功能降低（甲旁减）的患者早期血钙、血磷处于临界状态或间歇性升高，常被漏诊。只有ＰＴＨ的测...     

免疫放射分析与电化学发光法测定全段甲状旁腺激素的比较

随着甲状旁腺激素(PTH)测定方法的不断发展,人们对其在骨疾病、肾疾病、血液透析的监测及病因学研究中的应用越来越广和深入。目前国内有通过测定血中N端、C端和M段PTH来反映PTH的活性水平,但准确性远远不如测定全段甲状旁腺素(intact PTH,iPTH)[1-2]。本文采用免疫放射分析(IRMA)、酶化学发光法和电化学发光法三种方法测定血清iPTH并分析IRMA和两种发光法的可信度及相关性,为各医院选择适合自己的测定方法提供依据。     

部分老年性非甲状腺疾病甲状旁腺激素测定结果的分析

应用放射免疫法对２４８你非甲关腺疾病的老年患者进行了甲状旁激素（ＰＴＨ）的测定，并与正常对照组进行了比较。结果表明：８１名健康老人血清ＰＴＨ含量明显高于正常中青年人（Ｐ〈０．０１），其中女性差异十分显著（Ｐ〈０．０１）。老年高血压、肿瘤、糖尿病、脑梗塞、慢性肾衰、肺炎与老年健康组相比差异十分显著（Ｐ〈０．０１）。提示：血清ＰＴＨ测定对于进一步了解老年人的非甲状腺疾病对ＰＴＨ分泌的调节具有重要作用。     

慢性肾衰竭患者全段甲状旁腺素测定的临床价值

近年来,越来越多的人注意到甲状旁腺素(PTH)在慢性肾衰竭(CRF)过程中所起的作用,甚至于有不少人认为高PTH血症实际上几乎可以解释全部尿毒症的症状.故本文对不同分期慢性肾衰竭(CRF)病人血清PTH与正常人PTH进行了检测分析,现报告如下.     

高通量血液透析治疗对尿毒症患者心功能、微炎症因子及血清磷、全段甲状旁腺激素清除的影响

目的:分析高通量血液透析治疗尿毒症的临床价值.方法:将2016年9月至2018年9月我院收治的263例尿毒症患者按治疗方式不同分为对照组(低通量血液透析,n=121)和观察组(高通量血液透析,n=142),比较两组患者治疗前与治疗3个月后心功能[左室舒张期末内径(Left ventricular end diastol...     

甲状旁腺激素和甲状旁腺99Tcm-MIBI显像联合应用在慢性肾功能衰竭诊治中的价值

目的 了解甲状旁腺激素和甲状旁腺99Tcm-MIBI显像联合应用在慢性肾功能衰竭诊治中的价值.方法 对我院83名慢性肾功能衰竭（CRF）患者检测血清PTH及血清Ca、磷（P）含量并进行甲状旁腺显像.结果 慢性肾功能衰竭组患者血清PTH含量明显高于健康对照组,差异有统计学意义（P＜0.01）;且慢性肾功能衰竭组患者的血清Ca、P含量与健康对照组比较差异有统计学意义（P＜0.05）.83名慢性肾功能衰竭患者双时相99Tcm-MIBI甲状旁腺显像中,69名患者发现甲状旁腺增生病灶72个（3名有两个增生灶,66名有1个增生灶）.结论 慢性肾功能衰竭患者中检测血清PTH含量可以及时了解病情对症下药,并对判断疗效及预后有重要意义,同时通过甲状旁腺显像明确诊断并通过术前显像定位增生病灶指导外科医生手术治疗.     

生化检查与免疫检查在肾脏疾病临床诊治中的应用

目的 对比不同检查方法在肾脏疾病临床诊治中的应用价值。方法 选取2014年7月~2016年7月我院接收的肾脏疾病患者90例,按照检查方法的不同分为观察组和对照组,每组45例。观察组采用生化联合免疫学检查,对照组单纯采用免疫检查。另选取45例同期健康体检者为空白组。对比两组疾病诊断准确率、患者满意度以及实验室各指标。结果 观察组诊断准确率（95.56%）明显高于对照组（84.44%）,差异具有统计学意义（P＜0.05）;观察组患者对检查方法的满意度评价（97.78%）远高于对照组（88.89%）,差异具有统计学意义（P＜0.05）;与体检健康者相比,观察组与对照组白蛋白、补体C3、补体C4相比明显降低,而血清尿素、肌酐、尿酸明显升高,差异具有统计学意义（P＜0.05）。结论 为肾脏疾病患者合理选择检查项目,采用生化免疫联合检查的方式可达到更高的诊断准确性,为临床诊疗提供重要参考依据,值得大力推广及应用。     

甲状旁腺激素荧光免疫层析定量检测技术的研制及应用研究

研制一种操作简易、灵敏度高的荧光免疫层析试纸条,用于定量检测甲状旁腺激素(parathyroid hormone,PTH)。采用双抗体夹心法和荧光免疫层析技术,将标记抗体LA001与荧光微球结合于聚酯膜结合垫上,检测抗体CA001包被在硝酸纤维素膜上作为检测线(T),另将质控抗体(羊抗鼠IgG)包被在相互平行的硝酸纤维素膜上作为质控线(C),过量的鼠源标记的荧光微球在质控线处聚集产生质控荧光信号,待测样中的PTH在T处形成包被抗体-PTH抗原-标记抗体的夹心复合物并产生荧光信号,通过荧光检测仪计算出定量结果。试纸条检测PTH灵敏度最低可达0.8pg/mL,与促甲状腺激素(thyroid stimulating hormone,TSH)无交叉反应,不同批次试剂4 oC放置6个月稳定性好,批内变异系数(coefficient of variation,CV)为5.32%,批间CV值为6.74%。与电化学发光免疫法(electrochemiluminescence immunoassay,ECLIA)比较相关性较好,R2=0.993,差异无统计学意义,甲状旁腺组织结果与非甲状旁腺组织结果则有明显差异(P0.01)。采用该荧光免疫层析试纸条,不仅可以提供较高的灵敏度和特异度,而且操作简单,适合临床工作的需要。     

Rapid Decrease of Intact Parathyroid Hormone Could Be a Predictor of Better Response to Cinacalcet in Hemodialysis Patients

Purpose

Cinacalcet is effective for treating refractory secondary hyperparathyroidism (SHPT), but little is known about the response rates and clinical factors influencing the response.

Materials and Methods

A prospective, single-arm, multi-center study was performed for 24 weeks. Cinacalcet was administered to patients with intact parathyroid hormone (iPTH) level greater than 300 pg/mL. Cinacalcet was started at a dose of 25 mg daily and titrated until 100 mg to achieve a serum iPTH level <300 pg/mL (primary end point). Early response to cinacalcet was defined as a decrease of iPTH more than 50% within one month.

Results

Fifty-seven patients were examined. Based on the magnitude of iPTH decrease, patients were divided into responder (n=47, 82.5%) and non-responder (n=10, 17.5%) groups. Among the responders, 38 achieved the primary end point, whereas 9 patients showed a reduction in serum iPTH of 30% or more, but did not reach the primary end point. Compared to non-responders, responders were significantly older (p=0.026), female (p=0.041), and diabetics (p<0.001). Additionally, early response was observed more frequently in the responders (30/47, 63.8%), of whom the majority (27/30, 90.0%) achieved the primary end point. Multivariate analysis showed that lower baseline iPTH levels [odds ratio (OR) 0.96, 95% confidence interval (CI) 0.93-0.99], the presence of diabetes (OR 46.45, CI 1.92-1125.6) and early response (OR 21.54, CI 2.94-157.7) were significant clinical factors affecting achievement of iPTH target.

Conclusion

Cinacalcet was effective in most hemodialysis patients with refractory SHPT. The presence of an early response was closely associated with the achievement of target levels of iPTH.     

血液透析对尿毒症患者全段甲状旁腺素的影响

用免疫放射分析，对１０例尿毒症维持血透患者透析时间和间期的血清全段甲状腺素，进行了测定。结果显示一次性血透可清除全段甲状腺素、血磷和补充血钙，有利于纠正患者钙磷人谢，但持续作用时间短暂。     

Immunolocalization of Parathyroid Hormone in Human Parathyroid Glands with Special References to Microwave Antigen Retrieval

The subcellular localization of parathyroid hormone (PTH) in the normal human parathyroid glands with particular reference to microwave antigen retrieval was investigated using peroxidase-labeled PTH antibody, immunohistochemical, and immunoelectron microscopic methods. The results revealed that PTH granules existed mainly as pro-PTH on the trans side of Golgi and in the regions adjacent to Golgi apparatus. Only a small proportion of secretory granules were stored near the plasma membrane. Microwave irradiation was essential for the immunodetection of PTH. As the irradiative time extended from 1 to 30 min, the staining intensity increased, and the subcellular preservation decreased. Microwave irradiation for 15 min (with the sections in citrate buffer) with a power output of 500 W is the most ideal for PTH antigen retrieval, as well as for subcellular preservation.     

PTH在CRF诊治中的应用

目的：探讨测定血清中甲状旁腺激素（PTH）的水平在慢性肾功能衰竭（CRF）诊治中的临床意义。方法：测定30例CRF患者血清PTH、25-（OH）VitD3和血钙,与健康人做对照。分别检测30例糖尿病肾病（DN）、高血压肾病患者血清内PTH浓度与血尿素氮（BUN）、血肌酐（Scr）的相关程度。结果：与正常对照组相比,CRF患者血清PTH水平显著升高,25-（OH）VitD3和血钙降低,差异有统计学意义（P〈0.05）。DN患者和糖尿病（DM）患者相比较,高血压肾病患者和高血压患者相比较,前者血清PTH水平均比后者要高,且与血BUN、Scr及尿中微量白蛋白（MA）与肌酐（Cr）的比值（MA/Cr）有较好的相关性。结论：CRF导致患者血清PTH浓度升高,测定血清PTH水平可作为判断肾功能的指标之一,更有助于临床对CRF的提早发现和及时治疗,对钙磷代谢的调节评价及预防继发性甲状旁腺功能亢进具有重要的临床意义。     

甲状旁腺素和降钙素对痛觉的中枢调节作用及其机理探讨

本文观察了脑室内注射甲状旁腺素(PTH)和降钙素(CT)对小鼠痛阈及对脑突触小体~(45)Ca摄取的彩响。结果表明,PTH(0.1U、0.4U、0.8U)均使小鼠痛阈明显降低,与此相反,CT(0.5U、1.0U、2.0U)则使小鼠痛阈显著上升,并有很好的量效关系。另外,PTH(0.5U、1.0U)明显促进脑突触小体对~(45)Ca的摄取,CT(1.0U、2.0U)则明显抑制~(45)Ca的摄取。结果提示,这两种激素可能通过影响中枢神经细胞Ca~(2+)的摄取,参与中枢的痛觉调节机制。     

肾脏疾患血液流变学指标的改变

肾脏疾患血液流变学指标的改变王吉永＊常乃秀＊随着血液流变学的不断发展、普及，其越来越广泛地用于临床疾病的诊断及治疗。本文对４２例不同类型的肾脏疾病患者进行了血液流变学指标测定，并与健康人作对照，发现部分指标有明显改变，现将结果报告如下。１资料与方法１...     

甲状旁腺素和二膦酸盐对激素性骨质疏松影响的超微结构观察

目的探讨应用甲状旁腺素和阿仑膦酸钠对激素性骨组织超微结构的影响。方法采用成年新西兰大白兔,随机分为对照组、激素模型组、甲状旁腺素和阿仑膦酸钠治疗组,每组10只,9周后取第4腰椎进行透射电镜下超微结构观察。结果对照组标本为成骨相和吸收相骨细胞;激素组大多为吸收相、退变相及死亡的骨细胞;治疗组主要为吸收相和成骨相骨细胞,吸收相骨细胞稍多。结论甲状旁腺素和阿仑膦酸钠能拮抗糖皮质激素对骨组织超微结构的影响。     

Parathyroid lesions: Difficult diagnosis on cytology

Cytology of parathyroid lesion (PL) is often confused with that of thyroid lesions. Differentiation between thyroid and PL is very difficult on cytomorphology because of their similar features and close anatomical proximity. Three cases of PLs reported on cytology in last one year were retrieved from archives of cytology department. Their cytomorphological details were studied and were correlated with the available biochemical parameters. Histopathology was available in two cases. Radiological assistance and parathyroid hormone (PTH) assessment in our cases formed the basis of diagnosing PLs on cytology. We discuss the differential diagnosis and pitfalls in cytological diagnosis of PLs. However, histopathology remains the gold standard for diagnosis. Interpretation of PLs on cytology remains problematic due to its rarity and limited available literature. The cytomorphology combined with clinical and biochemical data supported by histopathology are necessary to improve the diagnostic sensitivity of PLs. Diagn. Cytopathol. 2016;44:704–709. © 2016 Wiley Periodicals, Inc.     

化学发光免疫分析定量检测乙肝病毒标志物方法学研究

采用碱性磷酸酶标记,金刚烷衍生物发光,自动化学发光分析仪测量等,进行乙肝病毒五种标志物化学发光免疫分析(CLIA)方法学研究.结果表明这五种标志物CLIA方法的精密度、灵敏度、回收率和临床符合率等技术参数均达到方法学和临床诊断的要求.CLIA方法比ELISA和RIA更简便、快速而实用,为临床诊断和科研工作提供了一种有用的检测手段.